What Did CHA's Carol Keehan Know and When Did She Know It?

Register news analysis: As threats to religious liberty escalate, critics say it’s time to establish who truly speaks for the Church in the United States.

Vice President Joseph Biden speaks on health care as Secretary of Health and Human Services Kathleen Sebelius (l) and Sister Carol Keehan, president and CEO of the Catholic Health Association of the United States (r) listen at the Eisenhower Executive Office Building of the White House July 8, 2009.
Vice President Joseph Biden speaks on health care as Secretary of Health and Human Services Kathleen Sebelius (l) and Sister Carol Keehan, president and CEO of the Catholic Health Association of the United States (r) listen at the Eisenhower Executive Office Building of the White House July 8, 2009. (photo: Alex Wong/Getty Images)

WASHINGTON — President Barack Obama on Feb. 10 confirmed that his administration was offering an “accommodation” to religious groups opposed to a controversial federal rule requiring private health plans to provide contraception and abortion services.

As reported in the media, church-affiliated employers would not have to directly cover those services; instead, their insurance plans would cover them.

The announcement prompted an expression of gratitude from Daughter of Charity Sister Carol Keehan, the president and CEO of the Catholic Health Association, and a polite, but wary response from the U.S. Conference of Catholic Bishops, which said they needed to study the proposed modification.

That evening, the bishops’ conference formally rejected the president’s “accommodation” as essentially meaningless.

For the rest of the weekend, amid a blur of news headlines and talking heads that offered conflicting judgments, the faithful in the pews struggled to determine what, if anything, had changed regarding the administration’s policy.

The contrasting responses from the CHA leader and the USCCB have left Catholics and the general public confused about who speaks for the Church on a matter of grave institutional concern and whether the Obama administration exploited a lack of clarity about that matter.

The dueling positions have fueled questions about the basis of Sister Carol’s endorsement: USCCB officials and health-care experts have since confirmed that the government has not issued any binding regulations that legally override the controversial contraception mandate finalized by the Department of Health and Human Services on Jan. 20.

Subsequent media coverage and interviews suggest that while the White House cleared its talking points with Sister Carol in advance of the president’s public address, the USCCB had been excluded from the administration’s deliberations.

“Obama has made clear who is part of his ideological coalition and who is not. Discussions on the structure and restructuring of the contraceptive policy were conducted between the administration and pro-choice and feminist groups. The institutions targeted by the mandate — particularly those represented by the United States Conference of Catholic Bishops — were not in the room,” stated Michael Gerson in a column published in The Washington Post today.

“The administration engaged in no substantive consultation with Catholic bishops, who were only called to receive pronouncements. Interest-group liberalism is alive and well in the Obama White House,” Gerson wrote.

Special Treatment?

However, media reports suggest that Sister Carol received special treatment from the White House. A Feb. 10 New York Times story reported that the president’s “accommodation” was designed specifically to address Sister Carol’s concerns, not those of the U.S. bishops.

“The fight was for Sister Carol Keehan — head of an influential Catholic hospital group, who had supported President Obama’s health-care law — and Catholic allies of the White House seen as the religious left,” reported the Times.

Richard Doerflinger, the U.S. bishops’ chief lobbyist on life issues, confirmed that the conference had not received the relevant documents regarding the reported “accommodation” until Friday evening and that more information arrived on “Saturday, Feb. 11, at 5:27pm.”

After the close of the Friday workday, said Doerflinger, the conference was finally able to sift through all the documents — only to conclude that nothing of substance had changed since the HHS final rule was approved last month.

That same rule had been “finalized without change,” said Doerflinger, who stressed one single point: “The only thing that has force of law is that same final rule. It’s still in place. The rest is something that might happen.”

The administration informed the USCCB that “some time in the coming months we will issue new rulemaking for organizations that are not exempt from the mandate,” Doerflinger said.

“An organization that morally objects to these services is not exempt,” said Doerflinger. “It is not able to give its employees a plan without this contraception mandate.”

In striking contrast to the USCCB’s conclusion,  Sister Carol greeted the president’s “accommodation” with enthusiasm. Her support was touted by the administration and cited in media coverage of the breaking story.

By Feb. 11, the White House blog had posted statements from Sister Carol, Catholic Charities USA and Planned Parenthood supporting Obama’s “accommodation.” However, the Catholic Charities USA statement, a modified version of that organization’s original and more enthusiastic response to the president’s move, could not be described as an endorsement.

Sister Carol, however, has not modified her response to the president’s overture. From the beginning, her endorsement asserted that religious-liberty concerns had been addressed.

But she did not specify how the president’s action had met the concerns of church-affiliated institutions, including the members of her association.

Did Sister Carol receive additional binding assurances or was she simply trusting the president to make good on his promise to a faithful ally?

A review of the CHA website suggests that its CEO and president does not, in fact, have all the facts. A new statement assures anxious members that the organization “will review the proposed new rules for the HHS mandate.”

“CHA looks forward to reviewing the specifics of the changes in the mandated benefits. Many members have called with questions about these since they were a concern as first published. On Friday, Feb. 10, 2012, we were notified that our organizations would not have to buy or refer employees for contraception and other services. We were also told that the self-insured plans would be accommodated in this. At this time, there are many unanswered questions about specifics. We now have the challenging work of reviewing the proposed rules, examining their impact and giving input before they are finalized.

“Because many members have asked about specifics in the rules and also the process for applying for the one-year exception, we have included links to the rules and to the guidance on the safe harbor with this email.”

“As more is known about this, we will be getting that information out to the membership as quickly as possible,” read the new statement.

But if the CHA has not established the specifics of the “accommodation,” why did Sister Carol endorse it?

Sister Carol did not respond to a request for clarification. Bishop Kevin Vann of Fort Worth, Texas, the episcopal liaison on the CHA board, referred requests for comment to the CHA.

It is still not clear whether the board approved Sister Carol’s statement on Feb. 10, as Sister Carol and Bishop Vann did not respond to questions regarding this point.

Who Speaks for the Church?

The confusion and possible institutional damage generated by Sister Carol’s public endorsement have led some Catholic experts in the health-care field to demand an accounting.

“On the basis of what information and what authority did she issue this endorsement? It’s embarrassing from a policy standpoint,” noted Paul Danello, an expert on civil and canon law issues in Catholic health care, who has received calls from Catholic hospitals worried about the implications of the HHS final rule.

“If the CHA board hasn’t authorized this, if she has no mandate from the USCCB, and if there are no legally binding documents, she is operating without any legal, governance or regulatory basis. That is a hell of a situation for a Roman Catholic nun that heads the Catholic Health Association to be in.”

Danello says it’s past time for Church leaders to address Sister Carol’s public statements and actions with regard to the formal Church policy on a complex and critical issue.

“It’s the right hand fighting against the left hand,” he said. “Who is speaking for the Church here? The Church needs to get its house in order.”

Joan Frawley Desmond is the Register’s senior editor.